Objective To investigate the effects of different blood pH of the recipients on ischemiareperfusion (I/R) injury to the transplanted lungs in rats. Methods Sixty-four pure bred male SD rats weighing 250-350 g were randomly divided into equal numbers of donors and recipients and the recipient rats were randomly divided into 4 groups(n = 8 each). Both donor and recipient rats were anesthetized with intraperitoneal (IP)ketamine 15 mg/kg and diazepam 6 mg/kg, tracheostomized and mechanically ventilated. In donor rats heparin 1 ml was injected via inferior vena cava and 4 ℃ LDP solution 40 ml was injected via pulmonary artery . The left lung was then removed and placed in 4℃ LDP solution and kept for 4 h. The left lung transplantation was performed using two-cuff-one-stent anastomosis technique. Before the transplanted lung was reperfused, the recipients' blood pH was adjusted to 7.4 (group Ⅰ), 7.2 (group Ⅱ), 7.3 (group Ⅲ) and 7.5 (group Ⅳ) by HCI and NaHCO3 solutions infused via femoral vein. After 2 h reperfusion, the transplants were removed for microscopic examination and determination of W/D lung weight ratio, MPO and SOD activities and MDA, TNF-α and IL-8 contents. Results SOD activity was significantly higher while MPO activity, and MDA, TNF-α and IL-8 contents in the lung tissue were significantly lower in group Ⅲ than in group Ⅰ . There was no significant difference in SOD and MPO activities and MDA, TNF-α, and IL-8 contents in the lung tissue among group Ⅰ , Ⅱ and Ⅳ. There was no significant difference in W/D lung weight ratio among the 4 groups. Microscopic examination showed that the histological damage was attenuated in group Ⅲ compared with the other 3 groups. Conclusion The I/R injury to the transplanted rat lungs can be effectively alleviated by reducing blood pH of the recipients to 7.3.

Objective To investigate the prevention and cure effects of irbesartan on diabetic nephropathy.Methods The tissues of kidneys were harvested for histomorphometry and transmission electron microscope observation.The nuclear factor-?B(NF-?B) activity was measured by electrophoretic mobility shift assays(EMSA) in renal tissue and the level of TNF-? was measured by radio-immunity in serum.Results The glomerular basement membrane thickening,the numbers of total glomerular cells and monocyt cells in a glomerulus in experimental group were less than those of the control group.The NF-?B activity and TNF-? level were positively correlated with glomerular basement membrane thickening.Conclusion The irbesartan can prevent and cure diabetic nephropathy by inhibiting NF-?B and depressing inflammatory response.

Objective To assess the analytical performance of three sensitive cardiac troponin Ⅰ assays and compare the clinical application to provide help in choosing the detection method for clinical laboratory. Methods A total of 474 serum samples were collected from apparently healthy subjects and a total of 112 serum samples were collected from patients presenting with symptoms suggestive of acute myocardial infarction. The functional sensitivities of three assays from Abbott, Beckman-Coulter and Ortho were determined ( CV = 10% ). The reference ranges have been established. The analytic performance was compared according to the assessment mode described by Apple. The relationship was compared among the different assays. The preliminary clinical application value for different detection methods has been evaluated and validated with self-established reference ranges. Results The functional sensitivities ( CV = 10% ) of the cTnI assays for Abbott, Beckman-Coulter and Ortho were 0. 030, 0. 04 and 0. 013 μg/L, respectively.The 99th percentiles of cTnI in healthy volunteers were 0. 021, 0. 02 and 0. 026 μg/L respectively. The analytical data of ROC curve showed that the area under curve (AUC) of the cTnI assays for Abbott,Beckman-Coulter and Ortho for diagnosis of AMI was 0. 852,0. 909 and 0. 910,respectively. There was no statistical difference between any two methods(Z1 = 1.18 ,Z2 = 1.21 ,Z3 =0. 026,all P ＞0. 05). There were good consistency between the 99th percentile obtained from our laboratory and suggested by manufacturers (Kappa value were 1. 000, 0. 730 and 0. 893 respectively, all P ＜ 0. 01 ). Conclusions The analytical performance of two cTnl assays is "clinical accepted" ,the other one is accepted according to guideline. All of them could detect cTnI in apparently healthy subjects. There exist differences among three assays, but their diagnostic characteristics for AMI are not significantly different.

Objective To assess the analytical performance of hs-cTnT and biological variations in healthy population as well as establish hs-cTnT reference intervals. Methods The serum samples from 100 acute myocardial infraction patients and 474 apparently healthy subjects were collected. The functional sensitivity,within- and between-run imprecision were determined. The hs-cTnT assay and con-cTnT assay were evaluated. The serum hs-cTnT levels were detected in apparently healthy subjects to establish reference intervals. Moreover,the long-term and short-term biological variations for hs-cTnT in healthy volunteers were assessed. Results The functional sensitivity of hs-cTnT was 0. 005 μg/L. The within- and between-run precision for lower level control(0. 014 μg/L) and higher level control(2. 500 μg/L) was 2. 97% vs 3. 64%and 0. 66% vs 1.01% ,respectively. The correlation between hs-cTnT assay and con-cTnT assay was good ( R2 =0. 972 ,P ＜0. 01 ). The 99th percentile in apparently healthy subjects was 0. 003 μg/L for women less than60 years, 0.008 μg/L for men less than 60 years, 0.015 μg/L for women above 60 years and 0. 021 μg/L for men above 60 years. The CVa, CVi, CVg and CVt of short-term biological variations in detecting hs-cTnT from 22 apparently healthy subjects were 3.8%, 4. 8%, 49.9% and 58.5%,respectively. The CVa,CVi ,CVg and CVt of long-term biological variations were 5. 3% ,6. 4% ,56. 6% and 68. 3% respectively. Conclusions The analytical performance of the hs-cTnT is better than con-cTnT assay,achieving acceptable level according to guideline. Our experimental result could provide the basis for the new high sensitivity cTnT assay in the diagnosis of acute myocardial infarction.

Objective To investigate the clinical features,karyotype,and the prenatal diagnosis for his sibling of a Chinese patient with rare ring chromosome 20 syndrome induced intractable epilepsy.Methods The clinical data of the patient diagnosed in Peking University People's Hospital were collected.The clinical manifestations,chromosome karyotype were summarized.Results The proband,a boy,started to show intermittent tonic seizures or atypical absence seizures and psychomotor retardation from the age of 11 months.Several anti-epilepsy drugs and globulin had been tried without effect.Common karyotype analysis and epilepsy-related genes analysis revealed no abnormality.However,abnormal karyotype 46,XY,r(20)(p13q13.3) in his peripheral blood lymphocytes was found by high resolution chromosome karyotype analysis with 550 G-banding,and the diagnosis of ring chromosome 20 syndrome,type Ⅱ was confirmed.The mother of the patient underwent amniocentesis at the midterm of the second pregnancy.The cultured amniocytes karyotypes were normal.The second child(a boy) of the family was 1 year old without epilepsy and the psychomotor development was normal.Conclusions Ring chromosome 20 syndrome is a rare human chromosome abnormality.The syndrome is associated with epileptic seizures,behavior disorders and mental retardation.Since karyotype testing is not a routine investigation for the patient with epilepsy,the diagnosis of ring chromosome 20 syndrome is usually delayed or misdiagnosed.The karyotype analysis should be considered for the etiological study of the patients with intractable epilepsy with unknown origin.

Objective To explore the consistency of the clinical serum creatinine results in Shanghai district and investigate the population distribution of apparently healthy people, modified MDRD formula adapted to Chinese population was used to estimate glomerular filtration rate and its distribution for further assessment of the clinical applicability of the eGFR.Methods A fresh pooled human serum sample with given IFCC's creatinine level from c.f.a.s.(calibration for automatic system) ,was used to calibrate the creatinine detecting systems of each participating hospital laboratory before every examination. Fourteen hospital laboratories successively conducted 6 experiments, and the test results were almost identical.They tested and studied the creatinine values of 6 837 ( male 3 289, female 2 132, children and teenagers 1 416)apparently healthy individuals, age from 0 to 99 years old, and estimated eGFR value of these apparently healthy individuals according to the documented eGFR formula [ eGFR = 175 × (Scr) -1.154 × (age) -0.203 ×0.742 (female) × 0.827 ] which was applied especially to Shanghai people.Results Before calibration,the inter-laboratory CVs of creatinine results varied from 3.1％ -9.1％, and after calibration, CVs decreased to less than 5％.A good consistency of the creatinine results was established among all these hospitals.The result of population distribution study of creatinine for men was 63.0-102.8 μmol/L,for women was 45.0-76.0 μmol/L, and for children and teenagers was 0-1 year old 11.0-77.0 μmol/L, 2 years old 15.5-33.3 μmol/L,3-5 years old 19.0-42.0 μmol/L, 6-19 years old 41.4-62.0 μmol/L.The Cr value were different between the male and femal [ male: ( 82.1 ± 10.9 ) μmol/L, femal: ( 59.4 ± 8.4 ) μmol/L, t =94.3 ,P <0.01 ＝ ;The eGFR value could decrease the sexual difference[ male: (79.1 ± 13.5) ml · ( min ·1.73 m2 ) -1, femal: (79.2 ± 13.6) ml · ( min · 1.73 m2 ) - 1, t = 0.266, P > 0.05 ].The difference of Cr and eGFR could not be eliminated between the groups divided by every 10 years(x2Cr =2 601 ,P <0.01 ;x2eGFR2= 1 105 ,P <0.01 ＝.Conclusions The pooled patients' sera could be used as calibrator for harmonizing of creatinine results among the laboratories. The reference rang of Cr should be differentiated by age and sex.Although eGFR can decrease the difference of sex, it cannot eliminate the difference of age.

Objective To establish the reference intervals of serum osteocalcin (OCN), C-terminal cross-linking telopeptide of type Ⅰ collagen (β-CTx) and total type Ⅰ procollagen N-terminal peptide (P1NP) by electrochemiluminescence assay. Methods According to the Clinical and Laboratory Standards Institute (CLSI) "CA8-A" document the appropriately healthy people, who were divided into three groups (men, premenopausal women, and postmenopausal women) by sex and pre- or postmenopausal status were screened. The levels of fasting serum of OCN,β-CTx, tPINP were detected by Roche Modular E170 electrochemical immunoassay. Results 393 appropriately healthy people consists of 112 men between the ages of 29 and 69 years, 148 premenopausal women between the ages of 29 and 69 years, 133 postmenopausal women between the ages of 29 and 69 years. The levels of serum OCN, β-CTx, tP1NP in men group were (15.33±4.76) μg/L, (413±189) ng/L, (42.15±17.14) μg/L, respectively. The levels of serum OCN, β-CTx, tP1NP in premenopausal women group were (12.99±4.53) μg/L, 265(30-820) ng/L, (36.43±14.23) μg/L, respectively. The levels of serum OCN, β-CTx, tP1NP in postmenopausal women group were (18.96±5.15) μg/L, (513±195) ng/L, 51.40 (8.98 -118.6)μg/L, respectively. Logarithmic transformation produced normal distributions for all markers but serum β-CTx of premenopausal women group and serum tPINP of postmenopausal women group. The 95% of the distribution intervals for serum OCN, β-CTx, tP1NP in men group was 6.00-24.66 μg/L, 43-783 ng/L, 9.06-76.24 μg/L, respectively. The 95% of the distribution intervals for serum OCN, β-CTx, tP1NP in premenopausal women group was 4.11-21.87 μg/L, 68-680 ng/L, 8.53-64.32 μg/L respectively. The 95% of the distribution intervals for serum OCN, β-CTx, tPl NP in postmenopausal women group were 8.87-29.05 βg/L, 131-900 ng/L, 21.32-112. 80 μg/L, respectively. Conclusions Compared with the reference intervals provided by manufacture, the reference intervals of three serum bone turnover markers established by our laboratory have great difference. Laboratory should pay attention to the reference intervals was cited.

Objective To set quality goals of conventional biochemical tests through the research of biological variation of the 32 routine items in Chinese population to provide the basis for Chinese clinical and laboratory standards.Methods According to the experimental designs and computing methods from foreign counterparts,the results of biological variation,individual indexes and quality goals were calculated through the serum detection of 22 subjects from clinical laboratory of Zhongshan Hospital in Shanghai (male 12,female 10,ages varying from 20 to 40 years old,median age 30) in short-term (five blood draws within one day at 8:00,10:00,12:00,14:00 and 16:00) and long-term (one blood draw at 8:00 in 6 weeks consecutively) and serum controls (mixed from healthy people).Results (1) Based on the results of shortterm and long-term biological variation in 32 routine itens,the individual indexes and quality goals were obtained.(2)The influence of diet on the biological variation of part of the test items could be observed,especially free fatty acid (the mean value of post-meal was less than pre-meal about 30％),and then followed by high-sensitivity C-reactive protein (the mean value of post-meal was lower than pre-meal about 20％) and triglyceride (the mean value of post-meal was higher than pre-meal about 10％).(3)There were some differences between the quality goals we accessed and the the indicators from Europe and CLIA.Conclusions (1)The results of apolipoprotein E and free fatty acid in this study made up for the inadequate of the European biology database.(2) Only a small part of the 32 routine items were affected by dietary factors.(3) Most quality goals obtained from this study generally consisted with Europe biology quality goals,but a few items existed different.(4)It's more practical and effective to use the results of biological variatiou than CLIA standards for setting up quality goals.

ObjectiveTo improve the recognition of lichen sclerosus (LS) involving the anterior urethral strictures and to investigate the outcome of urethroplasty using free mucosal grafts for the treatment of urethral strictures caused by LS. MethodsFrom January 2007 to December 2010,36 patients with anterior urethral strictures caused by LS were treated using oral mucosal grafts or colonic urethroplasty.The mean age was 41 years (range,27 -75) and the mean anterior urethral stricture length was 11.5 cm (range,5.0 -20.0 cm).Of the 36 patients,27 patients underwent dorsal lingual mucosal graft or combined buccal mucosal graft urethrography.Eight patients underwent colonic mucosal urethrography according to the length and seriousness of urethral strictures,and the remaining patient underwent anterior urethral split.Biopsies were taken from the glans,urethral meatus and urethra before urethroplasty. ResultsThe urethral silicone stent was removed 21 d post-operatively and all the patients voided well.An epithelial-stromal lesion characterized by hyperkeratosis,thinned epithelium and diffuse perivascular lymphocyte infiltrate was seen upon histological examination of the biopsied areas.The mean follow-up was 22 ( range,6 - 50) months post-operatively.Meatal stenosis developed in 2 patients undergoing oral mucosas urethroplasty and 1 patient with colonic urethroplasty,the patients voided very well after re-operation.The other patients voided well and the urinary peak flow rates ranged from 17.2 to 47.0 mL/s ( mean,23.4). ConclusionsFree mucosal grafts urethroplasty can obtain good results for the treatment of urethral strictures caused by LS.But there is a risk of recurrence of urethral stricture and closing follow-up is required,especially for meatal stenosis.

ObjectiveTo investigate the long-term outcome of urethral reconstruction using colonic mucosa grafts for the treatment of long-segment,complex urethral strictures and to identify clinical factors that impact long-term outcomes. MethodsForty-six patients underwent colonic mucosal graft urethroplasty from October 2000 to September 2009 were retrospectively reviewed.The mean age was 39 years ( range,17 -70).The patients underwent an average of 2.7 prior unsuccessful repairs and the mean length of urethral strictures was 15.2 cm (range,10.0 to 20.0).The voiding status of all patients was evaluated postoperatively.Some of the paitents underwent uroflowmetry.urethrography and urethroscopy.Successful repair was defined as voiding well with urinary peak flow greater than 15 ml/s without the need for any post-operative procedures,such as dilatation. ResultsUrethral reconstruction was done with colonic mucosa grafts 11.0 -21.0 cm long (mean 15.4).One patient was lost to follow-up.Mean follow-up in the remaining cases was 62 months ( range 20 - 120 ).Complications related to urethroplasty developed in four patients (8.9％).Of these patients,meatal stenosis developed in three patients at 3,8 and 24 months respectively.Anastomotic site stricture occurred at the neourethra and proximal urethra in one patient at 29 months.In another two patients,recurrent strictures unrelated to urethroplasty were found. ConclusionsColonic mucosa graft urethroplasty could be an effective technique for the treatment of complex urethral strictures or panurethral strictures.The factors that impact long-term outcomes are meatal stenosis and stenosis at the anastomosis.